Journal of critical care
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Journal of critical care · Dec 2014
ReviewA systematic review of teamwork in the intensive care unit: What do we know about teamwork, team tasks, and improvement strategies?
Teamwork is essential for ensuring the quality and safety of health care delivery in the intensive care unit (ICU). This article addresses what we know about teamwork, team tasks, and team improvement strategies in the ICU to identify the strengths and limitations of the existing knowledge base to guide future research. ⋯ Team research is burgeoning in the ICU, yet low-hanging fruit remains that can further advance the science of teams in the ICU if addressed. Constructs must be defined, and theoretical frameworks should be referenced. The functional characteristics of tasks should also be reported to help determine the extent to which study results might generalize to other contexts of work.
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Journal of critical care · Dec 2014
ReviewThe ketamine effect on intracranial pressure in nontraumatic neurological illness.
The purpose of the study was to perform a systematic review of the literature on the use of ketamine in nontraumatic neurological illness and its effects on intracranial pressure (ICP). ⋯ There exists Oxford level 2b, GRADE C evidence in adults and level 4, GRADE C in pediatrics to support that ketamine does not increase ICP in nontraumatic neurological illness when patients are sedated and ventilated, and in fact may lower it in selected cases.
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Journal of critical care · Dec 2014
ReviewNeurocritical care complications of pregnancy and puerperum.
Neurocritical care complications of pregnancy and puerperum such as preeclampsia/eclampsia, hemolysis, elevated liver enzymes, low platelets syndrome, thrombotic thrombocytopenic purpura, seizures, ischemic and hemorrhagic stroke, postpartum angiopathy, cerebral sinus thrombosis, amniotic fluid emboli, choriocarcinoma, and acute fatty liver of pregnancy are rare but can be devastating. These conditions can present a challenge to physicians because pregnancy is a unique physiologic state, most therapeutic options available in the intensive care unit were not studied in pregnant patients, and in many situations, physicians need to deliver care to both the mother and the fetus, simultaneously. Timely recognition and management of critical neurologic complications of pregnancy/puerperum can be life saving for both the mother and fetus.
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Journal of critical care · Dec 2014
Observational StudyGoal-directed therapy after cardiac surgery and the incidence of acute kidney injury.
The purpose of this study was to assess the effect of goal-directed therapy (GDT), after cardiac surgery, on the incidence of acute kidney injury (AKI). ⋯ Postoperative GDT in patients after cardiac surgery was associated with reduction in the incidence of AKI and a reduction in ICU and hospital duration of stay.